Management of split-thickness skin graft donor site: A prospective clinical trial for comparison of five different dressing materials

Abstract

Introduction: Split-thickness skin grafting (STSG) is a frequently used reconstructive technique but is associated with a large variation regarding the management of the donor site. The aim of this study is to compare five different dressings for management of the STSG donor site in a prospective trial. Patients and methods: 100 consecutive patients, in whom reconstruction with STSG was performed, were included into the study. The grafts are harvested in a standard manner and the donor sites were dressed with one of the following materials: Aquacel (R) Ag, Bactigras (R) with Melolin (R), Comfeel (R) Plus Transparent, Opsite (R) Flexigrid and Adaptic (R). The materials are compared regarding to the time required for complete epithelialization, pain sensed by the patients, incidence of infection, scar formation, ease of application and the cost. Results: The earliest complete epithelialization was observed for Aquacel (R) Ag and the latest for Bactigras (R) with Melolin (R) Comfeel (R) Plus Transparent was the most painless dressing and Bactigras (R) with Melolin (R) was the most painful. The incidence of infection was highest for Bactigras (R) with Melolin (R) Opsite (R) Flexigrid was the most economical dressing and Aquacel (R) Ag was the most expensive one. Conclusion: The aim is to provide the earliest complete epithelialization with minimal patient discomfort and lower cost in management of the STSG donor sites. None of the tested materials were ideal regarding these criteria, but Comfeel (R) Plus Transparent, as the least painful and one of the most economical materials, may be offered as the dressing of choice among the tested materials. (C) 2009 Elsevier Ltd and ISBI. All rights reserved.